HSM542: Physician-assisted Suicide Paper
Q.1 Write reply/response. (Melissa)
The legal aspect of physician-assisted suicide is a hot topic with one caviar that people are living longer and the opportunity for abuse. In the state of Massachusetts, there are cases to protect physicians who assist patient suicide. Dr. Roger Kligler (2020) filed suit for a judge to rule on doctors would not be charged with manslaughter. Also, the ruling stated that the physician could advise and offer information to the patient. The prosecutor focused on two factors, points in favor of the judge ruling, was on abuse, and the public voted 51 to 49 in favor of not legalizing physician assistant suicide (Bebinger & Goldberg, 2020). People have their points of view about the rights to die with dignity and who has the right to determine or control their decision making. Their several states considering legalizing physician assistant suicide with restrictions to mitigate abuse (Bebinger & Goldberg, 2020).
Reference
Bebinger, M., & Goldberg, C. (2020, January 10). Mass. Court rules patients don’t have a right to physician-assisted suicide, but doctors can discuss it. WBUR. Retrieved from https://www.wbur.org/commonhealth/2020/01/10/mass-court-right-to-die-ruling
Q.2 Write reply/response. (Rhonda)
Professor and Class,
Oregon’s Death with Dignity Act is a statute that allows a mentally competent adult diagnosed with a terminal illness to remain in control during his /her final days, by asking for and receiving a prescription medication to hasten his death. It allows a terminally ill person should have the right to decide when, where, and how his death occurs.
The legal and moral implications of physician-assisted suicide (PAS) specifically relating to this act includes:
- It encourages a patient’s right to choose to die/self-autonomy.
- Relieves the physical and emotional suffering for the patient/ inhumanity of a visual declination of the physical body.
- Contradicts the Hippocratic Oath to do no harm/physician against prescribing a lethal drug.
- Unethical morally to take a life from religious perspectives- “Thou shall not kill.”
Financially for patients who desire PAD, believes it reduces the financial burden to their families. According to the Dying with Dignity organization, they cannot confirm who pays for these services-patient or the insurance company. This is based on whether the “its classified as an elective or procedure. Additionally federal funding, including Medicaid and Medicare, cannot be used for services or medications received under these laws.
The reason all 50 states or federal legislation haven’t passed this act is due to the fact while the U.S. Supreme court ruled in 1990 that patients or their designated health care agents may refuse life-preserving medical treatment. However, not all physicians want to take an active role in assisting the death of a patient. In my state of Illinois, this act has not been passed. Even if the law is passed it is still a voluntary option for physicians participation.
Q.3 Write reply/response. (p.Acosta)
Hello Professor and Class,
Death with dignity laws, also known as physician-assisted dying laws, this is for people who are terminally ill, also for their end-of-life decisions that will determine, how much pain and suffering they should endure. these laws are also known as physician-assisted dying laws, death with dignity statutes will allow mentally competent adults state residents who have a terminal illness along with prognosis, or having six months or less medication to hasten and the inevitable, immune voluntarily request and receive prescription medication, By adding a voluntary notion to a continuum of end of life, these laws will give patients.
Existing Physician-assisted dying laws will mirror Oregon’s Death with Dignity Act, which is widely an acclaimed successful and independent study with proof that has safeguards to protect patients and will prevent misuse. The death with dignity process will be robust. Two physicians must confirm the patient’s residency, diagnosis with prognosis, mental competence, and also voluntaries of the request. Two waiting periods, the first between the oral request, for the second between receiving and filling the prescription, are required.
https://deathwithdignity.org/learn/death-with-dignity-acts
Q.4 Write reply/response. (Zenobia)
If you were the CEO of the organization that cared for a patient similar to Terri Schiavo, Karen Quinlan, or Brittany Maynard, what issues would you consider most critical for your ethics committee to consider in that case and why? If I were the CEO of an organization that cared for a patient similar to these patients I would first make sure that all documents, advance directives and power of attorney paperwork was in place. In these cases it is hard to make decisions like this. Husband/wife and adult children, and parents of the patients need to come to an agreement on who has the final say over the patient. I would want to know the relationship between the husband and wife. Like if they were separated when the spouse became ill, and the relationship between the patient and the kids, and the relationship between the parents and the patient. Studies show concerning trends about the decision making process, which underlies how diagnosis and treatment dialogues progress. Shared decision making (SDM) provides a vehicle to honor both the provider’s expert knowledge and the patient’s right to be fully informed of all care options, and the potential harms and benefits. Consistent with the principles of patient-centered care, SDM is defined as a collaborative process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and
preferences ( Informed Medical Decisions Foundation, 2016a ). The concept of SDM supports autonomy through building strong relationships among
all stakeholders of the care process while respecting individual competence and interdependence on others ( Elwyn et al., 2012 ).
Q.5 Write reply/response. (Nichoals)
Dear Professor and Class, if I was the CEO of the organization that cared for a patient similar to the parties described above, the issues I would consider most critical for the ethics committee to consider are :
- Lay all facts on the table
- Build clear and concise decision tree that surroundings clear values that benefits importance pertaining to delivery of patient care
- Respect patient choice
- Respect family’s perspective and choice
- Ask the right questions rather then second guess the treatment or what you believe is the right move, its not about you as the doctor or even the ethics committee
- Moral obligation that does not impede on patients wish
All of these elements are critical because they remain connected to the patient which should be the north star focal point, always. If it is absolutely difficult to obtain what the patient would have wanted given the state the patient was in, the majority should clearly be the deciding factor what kind of person he/she was based on gathering facts from family, friends, spouse, passed doctors.
I find it shocking Brittany and her family had to go through below which is a resource wasting, mentally draining, experience on top of her brain tumor diagnosis she has already been battling
Q.6 Write reply/response. (Maria)
Good Evening Professor and Class,
Terri Schiavo was 26-years-old in 1990 when she fell into her persistent vegetative state. She suffered a heart attack which resulted in a severe lack of oxygen and brain damage. Every doctor who examined her believed she had a chance to recover. She was 41 when she died after having her feeding tube removed, a battle her husband fought for the 15 years she lived in a vegetative state.
If I were the CEO, issues I would consider were I to deal with a patient similar to Terri Schiavo would be as follows:
- What is the patient’s ultimate prognosis?
- Would assisting in the end of this patient’s life be considered murder by the law?
- What quality of life does the patient have now? What quality of life will they have in the future?
- Is there any possibility of a cure?
- How much suffering will they endure if they stay alive?
- Is there any harm being caused if she lives? Or if she dies?
I too remember watching the Terri Schiavo case play out on TV over the course of many years. Even then, I wondered why her family was allowing her to suffer like this? It felt as if they kept her alive for their own selfish reasons and that she was made to suffer unnecessarily. They did this because they believed they were not in a permanent coma. They were wrong. “An autopsy definitively settled that question. Her brain was severely atrophied, weighing less than half of what it should have. No treatment then or now could have reversed the brain damage she suffered. She was not conscious for all those years and never again would be” (Caplan, 2015).
Reference:
Caplan, A. (2015). Ten Years After Terri Schiavo, Death Debates Still Divide Us. Retrieved from https://www.nbcnews.com/health/health-news/bioethicist-tk-n333536